The Story of Anza Mapema: A Journey of Empowerment and Innovation in HIV Prevention
Anza Mapema stands as a testament to the power of community-driven change in the fight against HIV among gay, bisexual, and other men who have sex with men (GBMSM), as well as transgender women in Kisumu, Western Kenya. What began as a modest research initiative has blossomed into a comprehensive program reshaping HIV prevention, care, and treatment in the region. Here's how it all unfolded:
The Early Days: Discovering a Hidden Community (2007-2010)
The story of Anza Mapema traces its origins to 2007, when a groundbreaking male circumcision randomized controlled trial (MC RCT) revealed an unexpected truth: a significant but hidden population of men who have sex with men (MSM) in Kisumu. Through informal interviews, researchers began to learn about the lives, struggles, and health needs of this community, which often faced stigma and discrimination. The discovery underscored the urgent need for tailored health services, along with a strong focus on confidentiality, safety, and reducing the risks of HIV transmission.
Turning Point: The Birth of Key Support Initiatives (2010-2015)
In 2010, a partnership between the Nyanza Reproductive Health Society (NRHS) and the University of Illinois at Chicago (UIC) launched a Respondent Driven Sampling (RDS) study. This study identified alarming HIV prevalence rates among men aged 18–62, with figures as high as 28.9% in men aged 25–29. These findings made it clear that urgent intervention was needed.
That same year, the Kisumu Initiative for Positive Empowerment (KIPE) was born, a status-neutral support group to provide psychosocial support, community empowerment, and visibility for GBMSM. KIPE quickly became a hub for advocacy and support, with its membership growing to 350 active participants, laying the foundation for what would later become Anza Mapema.
Institutional Growth and Expansion of Anza Mapema (2015-2021)
In 2015, the Centers for Disease Control and Prevention (CDC) provided critical funding to scale up the work started by KIPE. This funding led to the establishment of Anza Mapema, which expanded its reach and services significantly. The program’s membership grew to over 1,000 active members, and the inclusion of transgender individuals within the program's scope was formalized.
By 2018, the program saw increased support from PEPFAR through LVCT Health’s STEPS program, and in 2021, the Center for International Health, Education, and Biosecurity-Kenya (CIHEB) continued the support through the ENTRENCH program. This collaboration enhanced HIV prevention, care, and treatment services, such as HIV testing, PrEP and PEP, STI screenings, and gender-based violence support, all aimed at reducing new infections and improving the quality of life for participants.
Impressive Outcomes and Ongoing Impact
By 2021, the ENTRENCH program had enrolled 844 MSM, achieving remarkable results: 227 participants began PrEP, 149 actively used it, and 81 HIV-positive individuals were receiving care, with a 97% viral suppression rate. This success is evidenced by the fact that no new infections were reported within the year—a significant milestone in HIV prevention.
Groundbreaking Research and Community Collaboration
The Anza Mapema program has always been committed to evidence-based solutions. The Anza Mapema Study, a landmark longitudinal cohort study funded by the CDC and EHPSA, followed 700 GBMSM over a year to better understand HIV incidence and the burden of STIs. The study revealed high rates of asymptomatic STIs, reinforcing the need for routine screenings and preventive care.
A key feature of the program’s success is its dedication to community-driven research. The Community Advisory Board (CAB), made up of representatives from LGBTIQ+ groups, religious leaders, law enforcement, and the legal sector, ensures that the program remains culturally sensitive and ethically grounded.
Advancing Prevention: Pioneering Studies and the Future
In 2019, the Tatu Pamoja study launched in Kisumu, Nairobi, and Kilifi, further strengthening HIV prevention among MSM and transgender women. The study is part of Anza Mapema's broader commitment to improving care strategies and evaluating new methods like PrEP retention.
Looking to the future, the 2024 Mbili Pamoja studies represent another leap forward. These studies explore microbiomes, immunology, and the host-pathogen dynamics of STIs, helping pave the way for innovations in STI diagnostics and vaccine development.
Anza Mapema Today
From its roots in grassroots support to its current status as a hub for cutting-edge research and HIV policy development, Anza Mapema continues to drive meaningful change. Through ongoing studies, partnerships, and the unwavering commitment of its community, Anza Mapema remains at the forefront of HIV prevention and care for GBMSM and transgender individuals in Kenya.
